NPIMap

Individual provider Active NPI

Jamie R Petzke, MD

  • Hospitalist Physician
  • Baraboo, WI
National Provider Identifier
1811459605
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
75717 Issued in WI
Practice address
707 14TH St
Baraboo, WI 53913-1539
Phone
(608) 356-1400
Fax
(608) 355-1833
NPI assigned
Apr 2, 2019
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 75717 WI Primary

Addresses

Primary practice location

707 14TH St
Baraboo, WI 53913-1539

Mailing address

1808 W Beltline Hwy
Madison, WI 53713-2334
Phone (608) 280-4647

Other names 1

  • Jamie R Wellman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026002165 WI Practitioner - Hospitalist 5294063970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
West Virginia University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sauk Prairie Healthcare IncGroup PAC ID 8224948054, 122 clinicians
SSM Health Care of Wisconsin IncGroup PAC ID 8527977867, 19 clinicians

Practice addresses (Care Compare)

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-7574

707 14TH St
Baraboo, WI 53913-1539
Phone (608) 356-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75717WIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Wisconsin, Inc. CurrentSince Jul 19, 2022 Accepting new patients
Sauk Prairie Healthcare, Inc. CurrentSince Aug 5, 2024 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
SSM Health Care of Wisconsin Inc Hospitalist CurrentSince Jul 19, 2022 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Surgical Associates CurrentSince Aug 5, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc Past Accepting new patients

Locations

7153 Solutions Ctr
Chicago, IL 60677

707 14th St
Baraboo, WI 53913
Phone (608) 356-1400

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9971/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jpetzke306067@direct-ehr-ssmhc.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1811459605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W BELTLINE HWY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132334",
            "telephone_number": "608-280-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1400",
            "fax_number": "608-355-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETZKE",
        "first_name": "JAMIE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "75717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "WELLMAN",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.